Multiparametric MRI of the Prostate: From Scientific Triumph to Daily Practice

(mpMRI) of the prostate consists of three parameters: high-resolution T2-weighted anatomical imaging (T2w), diffusion-weighted imaging (DWI), and dynamic contrastenhanced (DCE) MRI. Minimal technical requirements for the acquisition of dedicated prostate MR-images have been described in the Prostate Imaging Reporting and Data System (PI-RADS), which currently is in its version 2.1 [1]. It also contains a standardized reporting system, which groups imaging findings on T2w, DWI, and DCE and yields a final categorization into a 5-point scale predicting the likelihood of clinically significant prostate cancer. The diagnostic performance of mpMRI of the prostate using PI-RADS has been amply studied in numerous highquality studies during the last decade. In 2017, a metaanalysis consisting of 21 studies, including 3857 patients, calculated a pooled sensitivity of 89% (range 73%–100%) and a pooled specificity of 73% (range 7%–100%) [2]. The large ranges can be explained by a number of factors.